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Chapter 15

1. During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is:

a. Decreased in the older adult.

b. Impaired in a patient with cataracts.

c. Stimulated by cranial nerves (CNs) I and II.

d. Stimulated by CNs III, IV, and VI. 

Rationale:

2. The nurse is testing a patient’s visual accommodation, which refers to which action?

a. Pupillary constriction when looking at a near object

b. Pupillary dilation when looking at a far object

c. Changes in peripheral vision in response to light

d. Involuntary blinking in the presence of bright light 

Rationale:

3. Which of these assessment findings would the nurse expect to see when examining the eyes of an African American patient?

a. Increased night vision

b. Dark retinal background

c. Increased photosensitivity

d. Narrowed palpebral fissures 

Rationale: 

4. A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The nurse should:

a. Examine the retina to determine the number of floaters.

b. Presume the patient has glaucoma and refer him for further testing.

c. Consider these to be abnormal findings and refer him to an ophthalmologist.

d. Know that floaters are usually insignificant and are caused by condensed vitreous fibers. 

Rationale: 

5. The nurse is preparing to assess the visual acuity of a 16-year-old patient. How should the nurse proceed?

a. Perform the confrontation test.

b. Ask the patient to read the print on a handheld Jaeger card.

c. Use the Snellen chart positioned 20 feet away from the patient.

d. Determine the patient’s ability to read newsprint at 12 to 14 inches. 

Rationale:

6. A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The nurse interprets these results to indicate that:

a. At 30 feet the patient can read the entire chart.

b. The patient can read at 20 feet what a person with normal vision can read at 30 feet.

c. The patient can read the chart from 20 feet in the left eye and 30 feet in the right eye.

d. The patient can read from 30 feet what a person with normal vision can read from 20 feet. 

Rationale:

7. A 2-week-old infant can fixate on an object but cannot follow a light or bright toy. The nurse would:

a.     Consider this a normal finding.

b.     Assess the pupillary light reflex for possible blindness.

c.     Continue with the examination and assess visual fields.

d.     Expect that a 2-week-old infant should be able to fixate and follow an object. 

Rationale:

8. The nurse notices the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. The nurse should:

a.     Check for the presence of exophthalmos.

b.     Suspect that the patient has hyperthyroidism.

c.     Ask the patient if he or she has a history of heart failure.

d.     Assess for blepharitis, which is often associated with periorbital edema. 

Rationale:

9. During an examination, a patient states that she was diagnosed with open-angle glaucoma 2 years ago. The nurse assesses for characteristics of open-angle glaucoma. Which of these are characteristics of open-angle glaucoma? Select all that apply.

a.     Patient may experience sensitivity to light, nausea, and halos around lights.

b.     Patient experiences tunnel vision in the late stages.

c.     Immediate treatment is needed.

d.     Vision loss begins with peripheral vision.

e.     Open-angle glaucoma causes sudden attacks of increased pressure that cause blurred vision.

f.      Virtually no symptoms are exhibited. 

Rationale:

SCIENCE
HEALTH SCIENCE
NURSING
NURS 1175

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